Successful extracorporeal membrane oxygenation therapy in a child with coronavirus 2019 disease-associated ARDS and chemotherapy for Ewing's sarcoma.

Most children and adolescents with SARS-CoV-2 infection show no or mild symptoms, but those with medical histories can be susceptible to more severe forms of disease. There are few reported cases of extracorporeal membrane oxygenation (ECMO) in pediatric patients with coronavirus disease 2019 (COVID-19). We present a previously healthy 13-year-old male diagnosed with metastatic Ewing's sarcoma at the same time as catastrophic acute respiratory distress syndrome due to COVID-19, who was successfully supported by venovenous-ECMO while he received the corresponding chemotherapy protocol.ECMO can be used as salvage therapy in oncology pediatric patients with respiratory failure secondary to COVID-19. In addition, successful chemotherapy can be administered while patients are supported on ECMO.

[Sickle cell disease diagnosis over a decade in a pediatric hematology unit]. / Experiencia de una década en el diagnóstico de la enfermedad de células falciformes en una unidad de referencia de hematología pediátrica.

Sickle cell disease (SCD) is an autosomal recessive hemoglobinopathy. The prevalence of SCD can change especially by migrations. OBJECTIVE: To describe the characteristics of patients with SCD at diagnosis, in a referral hospital over a decade. PATIENTS AND METHOD: Retrospective study of the cli nical and laboratory characteristics of children under 15 years of age with SCD, diagnosed in the Onco-Hematology Service of the Hospital Dr. Roberto del Rio, Santiago, Chile, between April 2008 and March 2018. Sex, age, nationality, symptoms, blood count characteristics, and hemoglobin elec trophoresis results were evaluated by descriptive statistical analysis. RESULTS: Sixteen patients were included, 2 were healthy carriers so were excluded from the analysis. Of the 14 analyzed, the diagnosis was made before 2015 in 2 patients. Twelve were male, 9 were Chilean, 13 had foreign parents. Eight were less than 2 years old and 12 were symptomatic. The most frequent symptoms were limb pain and anemia. Median hemoglobin was 8.2 g/dL (6.2-12.3), in 11/14 sickle cells were observed, in 4 by metabisulfite test. In 13/14, hemoglobin electrophoresis was performed, median hemoglobin S 70.2% (28.2-87.1) and hemoglobin F 18.7% (0-32.3). Only one patient had a genetic study. Thirteen patients were still in follow-up, 84.6% of them received folic acid and amoxicillin, 53.8% required transfusions, and 69.2% started hydroxyurea. CONCLUSION: SCD has increased in Chile; therefore, a high degree of suspicion is required. The diagnosis, treatment, and follow-up of this pathology should be improved at the local level.